Too many CT scans ordered on children
This morning I read a post by a pediatric intensive care (PICU) doctor who admitted too many CT scans are still being given to children, despite recent evidence that radiation exposure from the scans carries a not insignificant future risk of cancer.
I posted about the results of this study a couple of months ago: Children are more “radiosensitive” than adults; CT scanners can vary dramatically in the amount of radiation exposure; and radiation exposure is cumulative–more CT scans relate to a higher risk.
This doctor focused on the overuse of … Continue reading
Inflated hospital costs
I read an article in the New York Times yesterday that initially infuriated me. The journalist, Nina Bernstein, wrote something of an exposé on the outrageous hospital costs incurred by a group of about 100 people after suffering from an outbreak of food poisoning.
She focused on the fact that a bag of normal saline IV solution costs the hospital anywhere from $0.44 to $1.
Some of the patients’ bills would later include markups of 100 to 200 times the manufacturer’s price, not counting separate charges for “IV administration.” And on other bills, a bundled charge for
… Continue reading
Even doctors are afraid of hospitals
One of my best friends is a physician, and we have an agreement: if either of us needs to go into the hospital for surgery, the other will be there to make sure everything is done right.
Hospitals are scary places, even for–especially for–health care professionals.
Dr. Laura Nathanson’s husband died as a result of incorrect diagnosis and delayed treatment due to poor communication between his doctors. To help inform and guide other families, she wrote a book, What You Don’t Know Can Kill You: A Physician’s Radical Guide to Conquering the Obstacles to … Continue reading
The unloved woman
I recently read two books that provoked my thoughts. The first was Twelve Patients: Life and Death at Bellevue Hospital by Dr. Eric Manheimer, the medical director of what is probably the largest public hospital in America.
Located in New York City, Bellevue sees patients from all demographics—incarcerated, homeless, undocumented, uninsured, mentally ill, addicted—and treats the worst trauma cases in the city.
Dr. Manheimer sees it all, and he writes compelling stories about the patients and their situations. He also comments on America’s health and health care in general.
His chapter entitled “The Unloved Woman” struck me … Continue reading
US News & World Report publishes hospital rankings for 2013
And the winner is…Johns Hopkins Hospital in Baltimore! Great, but what does that mean?
Every July US News & World Report publishes a list of what it considers to be the best hospitals in America.
The rankings are mostly based on an analysis of death rates for certain complicated procedures, patient safety statistics acquired from Medicare data, and a physician survey (which hospital do you think is best?)
Because the analysis requires enough patient data to make a judgement, the list is dominated by large, urban, university-affiliated medical centers. Like … Continue reading
That’s a good question!
H. Gilbert Welch, MD, the author of Overdiagnosed: Making People Sick in the Pursuit of Health, wrote a recent op-ed in the New York Times in which he wonders at what point will the high costs—and profits—of medical care in America be considered “a crime”?
Medical care is intended to help people, not enrich providers. But the way prices are rising, it’s beginning to look less like help than like highway robbery. And the providers — hospitals, doctors, universities, pharmaceutical companies and device manufacturers — are the ones benefiting.
The crime of perverse incentives
Although … Continue reading
The classic black comedy of medical training
The emotional and physical traumas of interns are well documented (if hilariously exaggerated) in The House of God by Samuel Shem. The “best medical students” become “terns,” the lowest of the low in the hospital hierarchy, and yet are expected to save lives on a daily basis, usually with little sleep and little or no supervision.
Shem, the pen name of a Harvard-trained physician, published “The House of God” in 1978 to provoke the medical education establishment and speak out against “the brutality of medical training.”
July 1, the hospital New Year
This … Continue reading
It seems to have been a busy week in health care news, and I found it difficult to settle on what interested me the most. But here are my picks:
Coke for breakfast?
Apparently that is one of the marketing strategies Coca-Cola is considering to increase its sales in the United Kingdom. It is not clear whether they mean to actually pitch the idea that a Coke would be a great accompaniment to a bowl of oatmeal (maybe an Egg McMuffin) or they mean to develop a new line of beverages to compete with tea and coffee. But sales of … Continue reading
I’ve finally realized there are just too many health-related news stories every week for me to comment on in a timely manner. And some news tidbits are interesting or funny, but really not worth a whole post.
But I would still like to share with you the stories that caught my eye over the week, so on Fridays I will start posting a weekly summing up, or “rounds” to use health care lingo, of what I have found of interest.
Don’t grocery shop when you’re hungry. Really?
In the did-we-really-need-a-study-to-tell-us-this? file, a research letter published in Journal of the American … Continue reading
Three years ago, my husband nearly died because of a series of medical mistakes. Although no one was guilty of clear medical malpractice (grossly negligent care resulting in harm), the hospital’s attempts to cut costs, a physician’s careless instructions, and a firewall of inflexible receptionists who refused to let me speak with a doctor led to a 911 call, a trip to the ER, and a 3-day stay in the ICU.
Luckily, he survived. But the resulting medical bills, as you can imagine, were enormous. And completely preventable.
Would it shock you to know that in 1999 the Institute of … Continue reading